Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 Hi Bruce, First of all congrats to the " Got it All " comment. New to this group but been in the Alt-Support-Impotence-ASI for a while trying to find answers. It seems like my symptoms pre your PCa parallell yours, and I would really appreciate your comments to my problems. This will be a long post, so please bear with me. There is a question at the end of it. I will show some hormonal test results, values being in accordance with the european norm, so you probably will find some numbers confusing. I am a wc male aged 54, heterosexual and with no medical history whatsoever until 2000. Height 179 cm (5´ 11´´) 68 kg (150 lb), former smoker. My father had a TURP at the age of 60. Due to a perceived medical problem (suspected heart condition) I went for my first physical check up in October 2000. The checkup was ok except for an arrhythmia of the heart (not perceived to be of any danger), the beginning of osteoporosis and a slightly enlarged prostate. My PSA values at the time were of no immediate concern, total less than 3 and Free/Total ratio at 28%. I was however starting to feel lethargic, slept a lot, had difficulty concentrating and had lost my usual zest for life. My T values were on the low side of normal (13 in a range of 9-35 nmol/l), Free T at the low end (54 in a range of 37-139 pmol/l), DHT at the low borderline (2.3 in a range of 2.10 – 10.30 nmol/l), E2 normal ( 105 when normal is below 220 pmol/l). Between 2000 and now my symptoms of T deficiency (which I believe is the culprit) have increased and now constitute major problems. Since a year or so more problems with loss of libido, ED and retarded ejaculation bordering on anorgasmia (Cialis/Viagra alleviates somewhat the ED, but not the anorgasmia). I feel no enthusiasm for anything, Small chores becomes projects. Formerly social and outgoing I am now a shadow of my former self. At the same time my PSA values have deteriorated; 4.17 in October of 2003, 5.30 in January 0f 2004 and 5.61 in June 2004. Free PSA / Toltal ratio has been 8% since Oct 2003. Ultrasound and palpation have been negative as has an 8 needle biopsy (Jan 2004). Prostate is supple, but enlarged, and I have some problems with BHP symptoms. The latest hormonal tests (taken June 2004) were (to me) not encouraging: Total T 10.5 (normal 9-36 nmol/l), Free T 28.6 (normal 37 – 139 pmol/l), DHT 0.72 (normal 2.10 – 10.3), E2 82 (normal below 220). LH was taken for the second time and showed 3.5 (normal 0.8 – 7.6 U / l), but was 4.6 in October of 2003. As 2003/4 progressed I became increasingly alarmed over my PSA values, BHP, ED and lack of mental / physical energy. In my search for answers (countless hours on the internet and in the library) I stumbled on the some of the articles on by Dr Liebowitz at http://www.prostatepointers.org/ and felt that I had found someone who reasoned the same way. Albeit a layman, I am a man of logic, and could not accept the " traditional " way of reasoning within the medical community. If indeed prostate/breast/ovarian cancers develop when our hormonal levels start to decline, how can the majority of scholars claim that hormones are harmful to these organs. I know that I am not a man of medicine, and I am aware of that there are many variables in the equation that I am not in a position to evaluate. However, after having read countless papers and abstracts on the prostate and hormones I am amazed that so few scholars have had the courage to question the " official truth " . The Emperor's new clothes revisited? Maybe I am totally wrong, I don't know, but there is so much contradictory information. During my latest visit with my urologist (he proposed a MRI scan and based on results one more biopsy), he did not advise PROSCAR or AVODART, as he believed they could wake a dormant Pca (probably based on very recent Swedish research by Prof. Jan-Åke Gustavsson). Maybe he hesitated due to my already very low DHT values. Also, French is my 4th language, so maybe something got lost in translation. He indicated that my PSA values could very well be explained by my BHP, but nevertheless wanted to dig further. He did prescribe Pradif (Tamsusoline) for symptoms, which by the way are not excessive. Both my urologist and physician are hesitant to embark on any TRT regime. I have indicated that this is the way I want to go, even if I risk something down the road. As it is now I have a half-life, waiting for and thinking of my next PSA results and a possible TURP in couple of years. I am fully aware of that I am more fortunate than others like you who have developed full-blown PCa, and if possible, I want to avoid that scenario. Somehow watchful waiting does not seem like a very promising road. For someone like you, having been down the road with TRT and Pca, would you have said no to TRT even if you knew the " official risks " ? Thank you and godspeed. Tomas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 Hi, I want to share something that may help you. Had a rather significant sinus infection that had been gradually getting more of a problem over a several weeks. The doctor prescribed a medication called Biaxin (Clarithromycin) 500mg for about a week maybe. Not sure if twice a day or not. Sure enough the infection went away but an unexpected symptom changed very drastically. My urine flow rate had been very low and suddenly the swelling in my prostate was reduced and the flow improved. I vaguely remember hearing some urologists put their patients on a long term antibiotic (like this one I figure) to reduce the PSA values even before doing biopsy tests. Evidently this is a relatively new approach to enlarged prostates. This medication is supposed to reduce bacterial infections by reducing the essential protiens needed to keep the bacteria alive. With the PSA values down you will probably be able to go ahead with TRT. You seem to be well informed on symptoms so you must have read a lot on the subject. I agree you are aiming at the right problem. I have been on hormone pellets long before the current patches, creams and such became available. I have been told the gradual dose without spurts of hormone, allows the body to accept the new high level without reacting and start converting T to E. Don't understand the TURP or PCa acronim. ernestnolan > Hi Bruce, > > First of all congrats to the " Got it All " comment. New to this group > but been in the Alt-Support-Impotence-ASI for a while trying to find > answers. It seems like my symptoms pre your PCa parallell yours, and > I would really appreciate your comments to my problems. This will be > a long post, so please bear with me. There is a question at the end > of it. I will show some hormonal test results, values being in > accordance with the european norm, so you probably will find some > numbers confusing. > > I am a wc male aged 54, heterosexual and with no medical history > whatsoever until 2000. Height 179 cm (5´ 11´´) 68 kg (150 lb), former > smoker. My father had a TURP at the age of 60. > > Due to a perceived medical problem (suspected heart condition) I went > for my first physical check up in October 2000. The checkup was ok > except for an arrhythmia of the heart (not perceived to be of any > danger), the beginning of osteoporosis and a slightly enlarged > prostate. My PSA values at the time were of no immediate concern, > total less than 3 and Free/Total ratio at 28%. I was however starting > to feel lethargic, slept a lot, had difficulty concentrating and had > lost my usual zest for life. My T values were on the low side of > normal (13 in a range of 9-35 nmol/l), Free T at the low end (54 in a > range of 37-139 pmol/l), DHT at the low borderline (2.3 in a range of > 2.10 – 10.30 nmol/l), E2 normal ( 105 when normal is below 220 > pmol/l). > > Between 2000 and now my symptoms of T deficiency (which I believe is > the culprit) have increased and now constitute major problems. Since > a year or so more problems with loss of libido, ED and retarded > ejaculation bordering on anorgasmia (Cialis/Viagra alleviates > somewhat the ED, but not the anorgasmia). I feel no enthusiasm for > anything, Small chores becomes projects. Formerly social and outgoing > I am now a shadow of my former self. At the same time my PSA values > have deteriorated; 4.17 in October of 2003, 5.30 in January 0f 2004 > and 5.61 in June 2004. Free PSA / Toltal ratio has been 8% since Oct > 2003. Ultrasound and palpation have been negative as has an 8 needle > biopsy (Jan 2004). Prostate is supple, but enlarged, and I have some > problems with BHP symptoms. > > The latest hormonal tests (taken June 2004) were (to me) not > encouraging: Total T 10.5 (normal 9-36 nmol/l), Free T 28.6 (normal > 37 – 139 pmol/l), DHT 0.72 (normal 2.10 – 10.3), E2 82 (normal below > 220). LH was taken for the second time and showed 3.5 (normal 0.8 – > 7.6 U / l), but was 4.6 in October of 2003. > > As 2003/4 progressed I became increasingly alarmed over my PSA > values, BHP, ED and lack of mental / physical energy. In my search > for answers (countless hours on the internet and in the library) I > stumbled on the some of the articles on by Dr Liebowitz at > http://www.prostatepointers.org/ and felt that I had found someone > who reasoned the same way. Albeit a layman, I am a man of logic, and > could not accept the " traditional " way of reasoning within the > medical community. If indeed prostate/breast/ovarian cancers develop > when our hormonal levels start to decline, how can the majority of > scholars claim that hormones are harmful to these organs. I know that > I am not a man of medicine, and I am aware of that there are many > variables in the equation that I am not in a position to evaluate. > However, after having read countless papers and abstracts on the > prostate and hormones I am amazed that so few scholars have had the > courage to question the " official truth " . The Emperor's new clothes > revisited? Maybe I am totally wrong, I don't know, but there is so > much contradictory information. > > During my latest visit with my urologist (he proposed a MRI scan and > based on results one more biopsy), he did not advise PROSCAR or > AVODART, as he believed they could wake a dormant Pca (probably based > on very recent Swedish research by Prof. Jan-Åke Gustavsson). Maybe > he hesitated due to my already very low DHT values. Also, French is > my 4th language, so maybe something got lost in translation. He > indicated that my PSA values could very well be explained by my BHP, > but nevertheless wanted to dig further. He did prescribe Pradif > (Tamsusoline) for symptoms, which by the way are not excessive. > > Both my urologist and physician are hesitant to embark on any TRT > regime. I have indicated that this is the way I want to go, even if I > risk something down the road. As it is now I have a half-life, > waiting for and thinking of my next PSA results and a possible TURP > in couple of years. I am fully aware of that I am more fortunate than > others like you who have developed full-blown PCa, and if possible, I > want to avoid that scenario. Somehow watchful waiting does not seem > like a very promising road. > > For someone like you, having been down the road with TRT and Pca, > would you have said no to TRT even if you knew the " official risks " ? > > Thank you and godspeed. > > Tomas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 > Hi, > > I want to share something that may help you....... > Thank you Ernest. I appreciate this and all your other posts both here and in the impotence group. When this (ED and stuff) hits us we need all the info and support we can get. TURP is the acronym for Transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). It supposedly is the GOLD standard for BHP, but has a few very unattractive side effects that we DON'T need. Read more here: http://www.informationtherapy.org/kbase/topic/detail/surgical/hw60259/ detail.htm PCa is short for Prostate Cancer. Thank you for the info. Will talk to my uroligist about it. Tomas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 I posted about high PSA and infection just the other day. www.drmirkin.com has some really good articles about this, though his answer to almost all problems is to try antibiotics first. His basic thinking is two-fold - if you're an older senior, prostate cancer is a 20+ year disease, and the biopsies and cure are worse than the disease, so why treat it if you're likely to die of other causes first anyways. For the younger crowd, and more importantly for anyone with elevated PSA, infection is as likely the cause as cancer. The doctor is supposed to massage the prostate, get a semen sample on a slide and look for white blood cells in the sample right away. If they're there, it's definitely infection and antibiotics are called for. Even if no white blood cells are seen, the slow progression of prostate cancer means it's safe to try a several month course of antibiotics prior to submitting someone to the horrible biopsy procedure where dozens of holes are punched through the colon into the prostate. If the antibiotic treatments lower the PSA, infection was probably the cause. This doctor also claims to have cured his wife of rhuematoid arthritis with like a year course of antibiotics. He makes compelling arguments in some of his downloadable articles and books on why antibiotics are always a good course to try, even though it's not mainstream thinking. Off topic, but another plug for Dr. Mirkin. For what it's worth, he seems ahead of the curve on many things. He was preaching using aldara cream for the treatment of non-genital warts several years ago as better than burning or freezing or cutting them out. I've developed dozens of little warts on the top of my foot, and the dermatologist PA I was seeing was freezing them off in a losing (and painful) battle. She told me that there was no cream to treat this. I happened to see another one in the clinic the other day and she said there was a new off-label use for aldara cream for all warts if I wanted to try it. IF only these dermatologists had heard of Dr Mirkin years ago. > Re: Prostate Cancer and TRT > > Hi, > > I want to share something that may help you. > > Had a rather significant sinus infection that had been > gradually getting more of a problem over a several weeks. The > doctor prescribed a medication called Biaxin (Clarithromycin) > 500mg for about a week maybe. Not sure if twice a day or not. > > Sure enough the infection went away but an unexpected symptom > changed very drastically. My urine flow rate had been very > low and suddenly the swelling in my prostate was reduced and > the flow improved. > > I vaguely remember hearing some urologists put their patients > on a long term antibiotic (like this one I figure) to reduce > the PSA values even before doing biopsy tests. Evidently > this is a relatively new approach to enlarged prostates. This > medication is supposed to reduce bacterial infections by > reducing the essential protiens needed to keep the bacteria alive. > > With the PSA values down you will probably be able to go > ahead with TRT. > > You seem to be well informed on symptoms so you must have > read a lot on the subject. I agree you are aiming at the > right problem. > > I have been on hormone pellets long before the current > patches, creams and such became available. I have been told > the gradual dose without spurts of hormone, allows the body > to accept the new high level without reacting and start > converting T to E. > > Don't understand the TURP or PCa acronim. > > ernestnolan > > > > Hi Bruce, > > > > First of all congrats to the " Got it All " comment. New to > this group > > but been in the Alt-Support-Impotence-ASI for a while > trying to find > > answers. It seems like my symptoms pre your PCa parallell > yours, and I > > would really appreciate your comments to my problems. This > will be a > > long post, so please bear with me. There is a question at > the end of > > it. I will show some hormonal test results, values being in > accordance > > with the european norm, so you probably will find some numbers > > confusing. > > > > I am a wc male aged 54, heterosexual and with no medical history > > whatsoever until 2000. Height 179 cm (5´ 11´´) 68 kg (150 > lb), former > > smoker. My father had a TURP at the age of 60. > > > > Due to a perceived medical problem (suspected heart > condition) I went > > for my first physical check up in October 2000. The checkup was ok > > except for an arrhythmia of the heart (not perceived to be of any > > danger), the beginning of osteoporosis and a slightly enlarged > > prostate. My PSA values at the time were of no immediate concern, > > total less than 3 and Free/Total ratio at 28%. I was > however starting > > to feel lethargic, slept a lot, had difficulty > concentrating and had > > lost my usual zest for life. My T values were on the low side of > > normal (13 in a range of 9-35 nmol/l), Free T at the low > end (54 in a > > range of 37-139 pmol/l), DHT at the low borderline (2.3 in > a range of > > 2.10 – 10.30 nmol/l), E2 normal ( 105 when normal is below 220 > > pmol/l). > > > > Between 2000 and now my symptoms of T deficiency (which I > believe is > > the culprit) have increased and now constitute major > problems. Since a > > year or so more problems with loss of libido, ED and retarded > > ejaculation bordering on anorgasmia (Cialis/Viagra > alleviates somewhat > > the ED, but not the anorgasmia). I feel no enthusiasm for anything, > > Small chores becomes projects. Formerly social and outgoing > I am now a > > shadow of my former self. At the same time my PSA values have > > deteriorated; 4.17 in October of 2003, 5.30 in January 0f 2004 and > > 5.61 in June 2004. Free PSA / Toltal ratio has been 8% > since Oct 2003. > > Ultrasound and palpation have been negative as has an 8 > needle biopsy > > (Jan 2004). Prostate is supple, but enlarged, and I have > some problems > > with BHP symptoms. > > > > The latest hormonal tests (taken June 2004) were (to me) not > > encouraging: Total T 10.5 (normal 9-36 nmol/l), Free T 28.6 (normal > > 37 – 139 pmol/l), DHT 0.72 (normal 2.10 – 10.3), E2 82 > (normal below > > 220). LH was taken for the second time and showed 3.5 (normal 0.8 – > > 7.6 U / l), but was 4.6 in October of 2003. > > > > As 2003/4 progressed I became increasingly alarmed over my > PSA values, > > BHP, ED and lack of mental / physical energy. In my search > for answers > > (countless hours on the internet and in the library) I > stumbled on the > > some of the articles on by Dr Liebowitz at > > http://www.prostatepointers.org/ and felt that I had found > someone who > > reasoned the same way. Albeit a layman, I am a man of > logic, and could > > not accept the " traditional " way of reasoning within the medical > > community. If indeed prostate/breast/ovarian cancers > develop when our > > hormonal levels start to decline, how can the majority of scholars > > claim that hormones are harmful to these organs. I know > that I am not > > a man of medicine, and I am aware of that there are many > variables in > > the equation that I am not in a position to evaluate. > > However, after having read countless papers and abstracts on the > > prostate and hormones I am amazed that so few scholars have had the > > courage to question the " official truth " . The Emperor's > new clothes > > revisited? Maybe I am totally wrong, I don't know, but there is so > > much contradictory information. > > > > During my latest visit with my urologist (he proposed a MRI > scan and > > based on results one more biopsy), he did not advise PROSCAR or > > AVODART, as he believed they could wake a dormant Pca > (probably based > > on very recent Swedish research by Prof. Jan-Åke > Gustavsson). Maybe he > > hesitated due to my already very low DHT values. Also, French is my > > 4th language, so maybe something got lost in translation. > He indicated > > that my PSA values could very well be explained by my BHP, but > > nevertheless wanted to dig further. He did prescribe Pradif > > (Tamsusoline) for symptoms, which by the way are not excessive. > > > > Both my urologist and physician are hesitant to embark on any TRT > > regime. I have indicated that this is the way I want to go, > even if I > > risk something down the road. As it is now I have a > half-life, waiting > > for and thinking of my next PSA results and a possible TURP > in couple > > of years. I am fully aware of that I am more fortunate than others > > like you who have developed full-blown PCa, and if > possible, I want to > > avoid that scenario. Somehow watchful waiting does not seem like a > > very promising road. > > > > For someone like you, having been down the road with TRT and Pca, > > would you have said no to TRT even if you knew the " official risks " ? > > > > Thank you and godspeed. > > > > Tomas > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 > I posted about high PSA and infection just the other day. > > www.drmirkin.com has some really good articles about this, though his answer > to almost all problems is to try antibiotics first. > Thanks Dave. Yes I went through a biopsy, like I guess quite a few other guys on this board. The standard treatment BEFORE any biopsy is to give a wide spectrum antibiotic, as it will prevent any infection caused by the (not very pleasurable) biopsy. But the patholologist examining the samples came back and stated that there were no infections abnormalities in the prostate samples. Nevertheless, an infection could have been caused by the intervention and causing my prostate ache, even if I am doubtful. Tomas Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 22, 2004 Report Share Posted August 22, 2004 Mirkin's point is it's LONG TERM antibiotics....not a week or two...months and months. Prostate infection would be deep rooted, hard to get rid of, the standard 5 - 14 day antibiotic runs just wouldn't affect it. He also claims to have cured arthritis, adult-onset asthma, and GERD with it. I got rid of my GERD with his triple-therapy protocol, which is now gaining wide-spread acceptance as standard treatment. > Re: Prostate Cancer and TRT > > > > > I posted about high PSA and infection just the other day. > > > > www.drmirkin.com has some really good articles about this, though > his answer > > to almost all problems is to try antibiotics first. > > > Thanks Dave. Yes I went through a biopsy, like I guess quite > a few other guys on this board. The standard treatment BEFORE > any biopsy is to give a wide spectrum antibiotic, as it will > prevent any infection caused by the (not very pleasurable) > biopsy. But the patholologist examining the samples came back > and stated that there were no infections abnormalities in the > prostate samples. Nevertheless, an infection could have been > caused by the intervention and causing my prostate ache, even > if I am doubtful. > > Tomas > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 23, 2004 Report Share Posted August 23, 2004 And yet other doctors freak out about too much antibiotic use because it can kill beneficial bacterial or cause resistent strains of bacterial. Makes you wonder how advanced in medicine we really are... just a good lesson though in that you have to be your own advocate and do your own research. If not for that (and groups like this one), I'd still not be getting treatment. Mark Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2004 Report Share Posted August 26, 2004 Also keep in mind that there is another option that Dr. and my endo use. They get your levels up using TRT and then add in HCG later. They seem to get very good results with the combo. Mark Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2004 Report Share Posted August 26, 2004 Broke another record. Still not a Dr. Regardless of how much T you take, if you do the hcG test and your testicles are capible of working it will ADD to that. If it does not add to it then you are primary. The trick is to be consistant. was on 2pkg androgel for over a month, did a total T and free T which gave me a baseline. This was Aug 11, due to lab problems will get these results on Monday. On Aug 13th did 5000 IU of hcG, continuing the 2 pkg androgel. on Aug 16th 72 hours after the shot did another total and free T. Those results did come back, go figure, Total T 1633 free T 550. Prior testing on one pkg androgel total T 213, free T 42.9. So even without the Aug 11 results this was fairly conculsive that I am 2ndary and not primary. Without Stopping the Androgel. Talk about a rush. Not sure if it is like getting a T shot have not had one of those yet, but about 1.5 hours after the shot my whole body came alive. It is hard to explain, but it was an amazing experience which repeated not as intense 2 days later. I knew before the blood was drawn that this stuff was working. Bob Bob > > I've already been through a three week stretch in no-TRT hell and my > > arrogant endo didn't do any testing, just put me right back on > > injections. > > If you intend to use exogenous t regardless of primary vs secondary, > there is no need to find that stuff out. That's probably why. > > > Short of repeating that torture is there any way to > > distinguish primary from secondary? > > > Sorry, but I cannot think of a reliable method of sorting that out > while on injections. > > If you are going with the combo treatment (hcg + test), I don't think > you have to distinguish primary from secondary. If you want to go on > hcg alone you'll need to be secondary. If you wanted, you could > simply discontinue the exogenous test and commence with hcg at > more-or-less the same time. If your test level falls too far over the > next few weeks, you'll know that you are primary since the hcg > treatment is failing. That is effectively an hcg stimulation test > (see AACE clinical guidelines) without the customary baseline t > reading. That's probably not a huge problem since you likely know > your approx t levels without treatment anyway. In the end, hcg alone > will be able to keep you at asymptomatic t levels or it won't and > you'll know in a few weeks. I have no idea of appropriate hcg doses > in this circumstance. If hcg alone fails, then you could re- introduce > exogenous t. The only advantage would be a shorter low t crash than > withdrawing all treatment for 3 or 4 weeks for diagnostic testing. > > > Fertility isn't a concern. Testicular volume might be an interest > > but if the size of the " boys " is all I get out of it, I'm have my > > doubts about the real benefit. Will it improve ejaculate volume and > > other sexual performance effects? > > > > Thanks Phil and Brad... > > I am not sure about ejaculate volume. If I recall correctly, it is > Dr. 's claim that the combo treatment (hcg + test) makes you feel > better (better libido) than test alone. I have no experience with that. > > Brad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2004 Report Share Posted August 26, 2004 > That is what my endo (idiot) suggested, but I was not willing to go > back into depression. I talked to my primary doc who agreed to run > the test I needed. Then I went online found an online doc to > perscribe/sell me hcG. My primary is now a beliver. > > The test I did. took Total and free T then did the 5000 IU of hcG 72 > hours later did another total and free T. > Remained on 2 pkgs of androgel the entire time so we would know how > much my testicles added. > > Bob > I considered this idea. If you get a large increase in t, this will work. If you got, say, and 800ng/dl increase, that'd be great. If there is an increase but not a large one, it doesn't necessary tell you that much if you are also taking exogenous t. I have primary hypo. My testicles can produce a little more than 400ng/dl. I am on injections so my lh and endogenous production is low. If I then did hcg, sure, I'd get an increase of perhaps a couple hundred ng/dls. Then, I'd think that I respond to hcg adequately. What I would miss is the fact while I respond to hcg, my total endogenous output is not enough to use hcg alone. In other words, if I am on exogenous t when doing the hcg, I can learn that I can go from zero or low to 400ng/dl but it doesn't make it obvious that I can't go from 400 to 800 on hcg alone. Brad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2004 Report Share Posted August 26, 2004 Hi, Don't know about this so I'll ask: would a clomiphene stimulation test show something to determine primary vs. secondary? I understand it would require some time off TRT, but I don't know for how long. Bruce > > Also keep in mind that there is another option that Dr. and my > > endo use. They get your levels up using TRT and then add in HCG > > later. They seem to get very good results with the combo. > > > > Mark > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2004 Report Share Posted August 26, 2004 Bobby, I would imagine that if you see a significant T increase when you go on HCG, that would probably mean you are secondary. But others here are way more knowledgeable than me on that kind of stuff. I did see a uro who is a male infertility specialist, and he told me he had been able to restart men's natural production using HCG and other meds after they had been on T replacement for a couple years. Mark --- In , " bobbycfromep " Is there any way to determine, after nine > months on TRT, whether I'm primary or secondary? > > Bobby > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 26, 2004 Report Share Posted August 26, 2004 Dr. and my endo add in HCG if you are secondary after getting levels up with TRT. I would imagine if you are secondary it will boost natural testosterone production. If you are primary I would think you would see no difference. Supposedly many men feel better on the combo - not sure what all it improves exactly, though. Mark > > Fertility isn't a concern. Testicular volume might be an interest > but if the size of the " boys " is all I get out of it, I'm have my > doubts about the real benefit. Will it improve ejaculate volume and > other sexual performance effects? > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2004 Report Share Posted August 27, 2004 I am hoping to beable to use only hcG. There are several people on this group that use both hcG and TRT. And some the hcG does nothing because of total testicular failure. hcG directly stimulates the testicles (lideg cells) it does this without regaurd for your T levels, no feed back loop. That is why body builders can use it mid cycle. Even on over doses of T the hcG still stimulates the testicles and they respond the best they can. Bob > > That is what my endo (idiot) suggested, but I was not willing to go > > back into depression. I talked to my primary doc who agreed to run > > the test I needed. Then I went online found an online doc to > > perscribe/sell me hcG. My primary is now a beliver. > > > > The test I did. took Total and free T then did the 5000 IU of hcG 72 > > hours later did another total and free T. > > Remained on 2 pkgs of androgel the entire time so we would know how > > much my testicles added. > > > > Bob > > > > I considered this idea. If you get a large increase in t, this will > work. If you got, say, and 800ng/dl increase, that'd be great. If > there is an increase but not a large one, it doesn't necessary tell > you that much if you are also taking exogenous t. > > I have primary hypo. My testicles can produce a little more than > 400ng/dl. I am on injections so my lh and endogenous production is > low. If I then did hcg, sure, I'd get an increase of perhaps a couple > hundred ng/dls. Then, I'd think that I respond to hcg adequately. > What I would miss is the fact while I respond to hcg, my total > endogenous output is not enough to use hcg alone. In other words, if > I am on exogenous t when doing the hcg, I can learn that I can go from > zero or low to 400ng/dl but it doesn't make it obvious that I can't > go from 400 to 800 on hcg alone. > > Brad Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2004 Report Share Posted August 27, 2004 Depends on how you want to start looking at the problem. For me I try to isolate failure points then work backwards. Given that the testicles make the testosterone the closer you can get to looking at them the better your chances of isolating the problem. There are 2 basic types of stimulation test described in the AACE guidelines. (in links section). Clomid and hcG. From somewhere on the web: Clomid stimulates the hypothalamus to, in turn stimulant the anterior pituitary gland (aka hypophysis) to release gonadotrophic hormones. The gonadotrophic hormones are follicle stimulating hormone (FSH) and luteinizing hormone (LH - aka interstitial cell stimulating hormone (ICSH)). FSH stimulates the testes to produce more testosterone, and LH stimulates them to secrete more testosterone. This feedback mechanism is known as the hypothalamic- pituitary-testes axis (HPTA), and results in an increase of the body's own testosterone production and blood levels rise. Human Chorionic Gonadotropin (HCG) This medication is a hormone which stimulates the ovaries and the testes. It is used in males to stimulate testicular descent or testicular growth and development. What is the advantage of one v.s. the other? Clomid, if this test is successfull you can restart the HPTA feedback loop. And you are done testing you know that you can get everything to work. If on the other hand it does not work then you have more digging to do. If it did not raise LH/FSH you know there is a problem upstairs but know nothing about downstairs so an hcG test would be needed. If LH/FSH were raised enough then you know there is a problem downstairs. From what I have read the Clomid test does require stopping or not yet starting TRT. hcG, if this test is successfull you know that your testicles are capible of doing there job. If it fails you know they are not. If successfull you may want to follow up with a Clomid test to see if upstairs can get working. hcG test does nothing* for the feedback loop so it can be done while on TRT. A high initial dose will restart dormant ledig cells. Bob > > > Also keep in mind that there is another option that Dr. and my > > > endo use. They get your levels up using TRT and then add in HCG > > > later. They seem to get very good results with the combo. > > > > > > Mark > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2004 Report Share Posted August 27, 2004 I am sure some of the benifits of hcG are psycological. When a man( i am being generic and everyone is different) finds out that he has low testosterone a lot goes through his mind. I am still a real man? what is wrong with my Jewels? Then he starts on TRT, fells better, but notices changes in those jewels. Changes could be shrinking and/or just a loss of sensation. This does a number on his head. Add hcG into the picture and the jewels get there feeling back and swell back up. It gives him his manhood back. Men can deal with a problem in there head much ezier then a problem in the plumbing. Just my opinion, Bob. Not a Dr. > Dr. and my endo add in HCG if you are secondary after getting > levels up with TRT. I would imagine if you are secondary it will > boost natural testosterone production. If you are primary I would > think you would see no difference. Supposedly many men feel better on > the combo - not sure what all it improves exactly, though. > > Mark > > > > > Fertility isn't a concern. Testicular volume might be an interest > > but if the size of the " boys " is all I get out of it, I'm have my > > doubts about the real benefit. Will it improve ejaculate volume and > > other sexual performance effects? > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2004 Report Share Posted August 27, 2004 I am a computer programmer for IBM. I never won a spelling bee. I enjoy SCUBA, rescue certified. I like camping, hiking, NASCAR, traveling, building things. My partner and I have been together for almost 11 years. Bob > > Dr. and my endo add in HCG if you are secondary after getting > > levels up with TRT. I would imagine if you are secondary it will > > boost natural testosterone production. If you are primary I would > > think you would see no difference. Supposedly many men feel > better on > > the combo - not sure what all it improves exactly, though. > > > > Mark > > > > > > > > Fertility isn't a concern. Testicular volume might be an > interest > > > but if the size of the " boys " is all I get out of it, I'm have > my > > > doubts about the real benefit. Will it improve ejaculate volume > and > > > other sexual performance effects? > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 30, 2004 Report Share Posted August 30, 2004 > In Dr s experience, ... The identical levels of > testosterone produced by Hcg versus HCG combined > with TRT, Will unfortunatly for most not offer the same > positive effects; the combined therapy of > HCG and trt being superior. Please elaborate. What superior " positive effects " does combined therapy offer over HCG alone? > > > > That is what my endo (idiot) suggested, but I was not willing to > go > > > back into depression. I talked to my primary doc who agreed to > run > > > the test I needed. Then I went online found an online doc to > > > perscribe/sell me hcG. My primary is now a beliver. > > > > > > The test I did. took Total and free T then did the 5000 IU of > hcG 72 > > > hours later did another total and free T. > > > Remained on 2 pkgs of androgel the entire time so we would know > how > > > much my testicles added. > > > > > > Bob > > > > > > > I considered this idea. If you get a large increase in t, this > will > > work. If you got, say, and 800ng/dl increase, that'd be great. If > > there is an increase but not a large one, it doesn't necessary tell > > you that much if you are also taking exogenous t. > > > > I have primary hypo. My testicles can produce a little more than > > 400ng/dl. I am on injections so my lh and endogenous production is > > low. If I then did hcg, sure, I'd get an increase of perhaps a > couple > > hundred ng/dls. Then, I'd think that I respond to hcg adequately. > > What I would miss is the fact while I respond to hcg, my total > > endogenous output is not enough to use hcg alone. In other words, > if > > I am on exogenous t when doing the hcg, I can learn that I can go > from > > zero or low to 400ng/dl but it doesn't make it obvious that I > can't > > go from 400 to 800 on hcg alone. > > > > Brad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2005 Report Share Posted January 6, 2005 OK take care. Phil Dale Beckes <dbeckes@...> wrote: Thanks for your kind thoughts Phil. Not that there's any difference really, but there's no wife here, but there is a " husband " who is very supportive. This is early enough that I am sure it can be treated - I just want to make sure I make an educated choice and can preserve my current quality of life afterwards. Thanks.../Dale Re: Prostate cancer and TRT Dale what did they do to tell you you have prostate cancer did they take a biopsie or you psa is up. I have some links for a dam good Dr. on this here they are. http://www.prostatepointers.org/prostate/leibowitz/TEST-REV2.html http://www.prostatepointers.org/prostate/leibowitz/ Phil nayaiu2b <dbeckes@...> wrote: Well, imagine my surprise yesterday when I was diagnosed with early stage prostate cancer. My homework assignment is to study the treatment options and to discuss with my urologist in 2 weeks. At this point, I do not know if he knows of my TRT (Testim 7.5gm/day), but am going to hazard a guess that when he does find out, that he is going to strongly advise my dropping it. I am hesitant to do so merely because prevailing opinion says that TRT and prostate cancer do not mix. I have read of reports that suggest that estrogens, and not T/DHT, are the blame for prostate problems. In fact, I read somewhere where at least BPH is treated with high dosages of DHT in Europe. Obviously this runs counter to conventional wisdom! I have looked through the Files and Links here, and can't seem to find any that concern the studies done on DHT vs E effects on the prostate, so was wondering if anyone here has knowldge of such documentation that I could study and possibly share with my urologist. Second question - are there others out there dealing with early prostate cancer and TRT, and if so, I would appreciate hearing your stories. We can take it offline if you'd rather - dbeckes@.... Lastly - anyone able to recommend a urologist, especialy if TRT friendly, in the Palm Springs area? Thanks.../Dale --------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2005 Report Share Posted January 6, 2005 Hi Dale, Congratulations on catching it early - that's the most helpful part of dealing with prostate cancer. I don't have to imagine your surprise, I've been there myself. I was diagnosed in March, 2000. Discontinued TRT in April. Operated on in June. After carefully considering the operating room report and pathology report The doctor was reasonably certain he'd gotten it all. On further deliberation with the surgeon I resumed TRT in October 2000. I strongly suggest finding a prostate cancer survivor support group near you. Members have gone through all the work and have answers to all your questions. They know the treatment choices and the best doctors, WTF a Gleason score means, the best diet, what to look for in a doc, what to ask for in a second opinion, how a surgeon will suggest surgery while a radiologist will suggest radiology, what books to read, impotence risks and rates (by procedure), which reports to get, etc. etc. etc. You want to find the best doctor you can, one who does the procedure over a hundred times a year. The American Cancer Society will be able to steer you toward a support group. With early detection the prognosis is usually good, but it can kill you, and it's not a nice way to go. Do whatever you can to increase your odds. If that includes stopping TRT on the CHANCE it would be helpful, well that's what I did. You can't do TRT if you're dead. I think future research will bear out that it's not the T, it's the imbalance. I'd love to see more evidence. I would not want to be the first person to rely on it. Bruce (PSA <0.1 for 4-1/2 years) > > Well, imagine my surprise yesterday when I was diagnosed with early > stage prostate cancer. My homework assignment is to study the > treatment options and to discuss with my urologist in 2 weeks. At > this point, I do not know if he knows of my TRT (Testim 7.5gm/day), > but am going to hazard a guess that when he does find out, that he > is going to strongly advise my dropping it. > > I am hesitant to do so merely because prevailing opinion says that > TRT and prostate cancer do not mix. I have read of reports that > suggest that estrogens, and not T/DHT, are the blame for prostate > problems. In fact, I read somewhere where at least BPH is treated > with high dosages of DHT in Europe. Obviously this runs counter to > conventional wisdom! > > I have looked through the Files and Links here, and can't seem to > find any that concern the studies done on DHT vs E effects on the > prostate, so was wondering if anyone here has knowldge of such > documentation that I could study and possibly share with my > urologist. > > Second question - are there others out there dealing with early > prostate cancer and TRT, and if so, I would appreciate hearing your > stories. We can take it offline if you'd rather - dbeckes@d... > > Lastly - anyone able to recommend a urologist, especialy if TRT > friendly, in the Palm Springs area? > > Thanks.../Dale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2005 Report Share Posted January 6, 2005 Dale, Sorry to hear about your diagnosis, but from my understanding it is one of the more treatable cancers if it is caught early enough. Bruce has had it, I'm sure he will reply with some good wisdom for you. It is my understanding that T does fuel prostate cancer growth if you have it but does not cause prostate cancer in and of itself. But I'm not sure about that - just basing that on what I think I remember others saying here. Mark Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2005 Report Share Posted January 7, 2005 Thanks, Bruce - great advice and very encouraging to hear of your success. By surgery, I assume you went the radical prostectomy (sp?) route, which is what I am leaning toward. Since that sounds like the only 98% sure thing way to go, and should remove what would otherwise be constant doubt/fear, then that makes the most sense to me. I'll still study the options I have, and take you up on your advice to find a local support group (local gets to be challenging - I work 500 miles from where I live, so not sure which area I'd consider local!). Thanks again, and congratulations on your great success - inspirational.../Dale Re: Prostate cancer and TRT Hi Dale, Congratulations on catching it early - that's the most helpful part of dealing with prostate cancer. I don't have to imagine your surprise, I've been there myself. I was diagnosed in March, 2000. Discontinued TRT in April. Operated on in June. After carefully considering the operating room report and pathology report The doctor was reasonably certain he'd gotten it all. On further deliberation with the surgeon I resumed TRT in October 2000. I strongly suggest finding a prostate cancer survivor support group near you. Members have gone through all the work and have answers to all your questions. They know the treatment choices and the best doctors, WTF a Gleason score means, the best diet, what to look for in a doc, what to ask for in a second opinion, how a surgeon will suggest surgery while a radiologist will suggest radiology, what books to read, impotence risks and rates (by procedure), which reports to get, etc. etc. etc. You want to find the best doctor you can, one who does the procedure over a hundred times a year. The American Cancer Society will be able to steer you toward a support group. With early detection the prognosis is usually good, but it can kill you, and it's not a nice way to go. Do whatever you can to increase your odds. If that includes stopping TRT on the CHANCE it would be helpful, well that's what I did. You can't do TRT if you're dead. I think future research will bear out that it's not the T, it's the imbalance. I'd love to see more evidence. I would not want to be the first person to rely on it. Bruce (PSA <0.1 for 4-1/2 years) > > Well, imagine my surprise yesterday when I was diagnosed with early > stage prostate cancer. My homework assignment is to study the > treatment options and to discuss with my urologist in 2 weeks. At > this point, I do not know if he knows of my TRT (Testim 7.5gm/day), > but am going to hazard a guess that when he does find out, that he > is going to strongly advise my dropping it. > > I am hesitant to do so merely because prevailing opinion says that > TRT and prostate cancer do not mix. I have read of reports that > suggest that estrogens, and not T/DHT, are the blame for prostate > problems. In fact, I read somewhere where at least BPH is treated > with high dosages of DHT in Europe. Obviously this runs counter to > conventional wisdom! > > I have looked through the Files and Links here, and can't seem to > find any that concern the studies done on DHT vs E effects on the > prostate, so was wondering if anyone here has knowldge of such > documentation that I could study and possibly share with my > urologist. > > Second question - are there others out there dealing with early > prostate cancer and TRT, and if so, I would appreciate hearing your > stories. We can take it offline if you'd rather - dbeckes@d... > > Lastly - anyone able to recommend a urologist, especialy if TRT > friendly, in the Palm Springs area? > > Thanks.../Dale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2005 Report Share Posted January 7, 2005 Hi Dale, About 20% of prostate cancer cases are detected with PSA in the " normal " range (<0.1- 4.0), but I agree your 3 years at 1.0 is surprising. Mine was 3.7, but had jumped from 1.8 the year before. Hats off to the PCP's who can detect this with the old digital rectal exam. Bruce At > my annual physical my PCP noticed a small lump on my prostate, so advised > that I see a urologist, who then performed the biopsy. PSA levels have > remained in the mid 1.0's for 3 years since starting TRT. This is why I was > so surprised to learn that despite low PSA, I had developed early stage > prostate cancer. -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 7, 2005 Report Share Posted January 7, 2005 Hi Dale, Yes, I had the radical retropubic prostatectomy, the so-called nerve-sparing procedure. At s Hopkins, by a protoge of the doctor who invented the procedure there. The guided-seed-implant procedure may be improved to surpass it some day, but in the meantime the RRP remains the " gold standard " . I wanted the most assurance that I had done the best with the least chance of recurrence. I wasn't thinking of it at the time, but the RRP is probably the best procedure if TRT is needed. There's a ranking of the top US urology hospitals at: http://www.usnews.com/usnews/health/hosptl/rankings/specihqurol.htm UCLA Medical Center in Los Angeles seems to be nearest you, ranked #4. I suggest getting your second opinion there (or higher up the list if travel is not an issue). Try to get it with a doc who does the procedure at least 50 times per year. A second opinion is almost mandatory with this. (I know of one guy who's second opinion was " The first opinion is wrong, you definitely don't have prostate cancer. " (!!!) My surgeon wrote the following in a letter to be shown to my TRT doc: " You asked me about testosterone treatment after surgery for your prostate cancer in a letter dated July 25 (2000). If your testosterone level is low, I believe that testosterone supplementation would be reasonable as long as your PSA level is undetectable. However, you must understand that if there are cells outside the prostate gland that we currently do not know about, testosterone may cause these cells to grow more rapidly. " Thought: The urology department at UCLA Medical Center probably knows of a support group near you. Online groups can provide a lot of information and encouragement, but there's something powerful in speaking face-to-face with people who've been through this. Best, Bruce > Thanks, Bruce - great advice and very encouraging to hear of your success. By surgery, I assume you went the radical prostectomy (sp?) route, which is what I am leaning toward. Since that sounds like the only 98% sure thing way to go, and should remove what would otherwise be constant doubt/fear, then that makes the most sense to me. I'll still study the options I have, and take you up on your advice to find a local support group (local gets to be challenging - I work 500 miles from where I live, so not sure which area I'd consider local!). --- Quote Link to comment Share on other sites More sharing options...
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